RETAG - Healthy workforce

Getting Healthy: It's Better All Together

Deck:

Our choices on matters of health are greatly influenced by our culture and environment—and the new Total Health Incentive Plan takes that into account

Story body part 1:

Holly Craft Moreno was a medical assistant in a geriatrics department. But she’d occasionally put in a few overtime hours at the infusion clinic at her hospital. One day, a young woman—a woman who was her father’s only daughter, who had not yet had children herself—came to the clinic for an infusion. Her prognosis was grim. As Moreno checked the patient in, she thought to herself, “This might have been prevented by a Pap smear.”

And when her shift ended, Moreno says, “I walked down the hall and scheduled an appointment with my ob/gyn.”

That day six years ago was the start of Moreno’s journey as a wellness champion at the Panorama City Medical Center in Southern California. A member of SEIU UHW, she’s been active in rallying her colleagues toward better health. One of her first projects was putting together a “Passport to Thrive,” a brightly colored checklist for recording the dates of preventive screenings and key health measures such as blood pressure and cholesterol.

This fall, efforts like hers are taking a giant leap—or perhaps Zumba shimmy—forward with Kaiser Permanente and the Coalition of Kaiser Permanente Unions announcing the details of a new Total Health Incentive Plan, the broad outlines of which were negotiated as part of the 2012 National Agreement. (Non-represented employees and most managers also will be included in the program.)

The plan is a bold, unprecendented step that acknowledges that ill health is not solely the result of individual choices and that chronic illnesses, which drive much of the high cost of health care, must be addressed collectively. It recognizes an employer can do a lot to support employees in creating better health habits.

“We’ve created a groundbreaking program around the health of our workforce, and it will have a legacy for decades to come,” says Kathy Gerwig, KP’s vice president of Employee Safety, Health and Wellness. “By building a community of support throughout the organization, we’re hoping it will be easier for healthy individuals to stay healthy—and that it will be easier for those with health risks and conditions to get the resources needed to improve.”

The program will track the overall progress of those covered by the incentive plan, region by region, on four key indicators of health—body mass index (BMI), smoking status, blood pressure and cholesterol. There will be a payout of $150 if 85 percent of managers and employees in a region have up-to-date health screenings by year-end 2014 and another $150 if 75 percent also take the total health assessment (THA). If both those goals are met, there’s another $200 if the region sees at least a 1.7 percent improvement in the at-risk population and there is no decline in any of the four areas being measured. (Get a one-page flier that explains the plan.)

Taking the THA—a confidential, online questionnaire that helps a person take stock of a wide range of issues affecting his or her health and offers personalized advice—can be a first step toward the improvements the plan aims for.

“You probably know if you aren’t eating enough vegetables or if you’re drinking too much—but the THA helps you become more immersed in creating an environment and awareness of healthy living,” says Cynthia Beaulieu, the union coalition’s Total Health labor lead in the Northwest region. As a result, she says, “you’re more likely to participate in it.”

The incentive program has been derided in some quarters, but most are applauding the effort to confront the prevailing belief that an individual’s choices on matters of health are independent of the culture and environment that person lives in.

“The forces are too strong for any one person or organization to do it alone,” says Roger Benton, the Healthy Workforce practice leader for the Southern California region. “There are unhealthy negative influences that we all get caught up in—stress, sedentary lifestyle, food choices—all of which lead to chronic illnesses.”

Shared interests

Like many other aspects of the Labor Management Partnership, the creation of the Total Health program came about because of a shared interest between management and labor: Improving the health of the workforce is a priority.

As SEIU UHW President Dave Regan points out, “If current trends continue, by the year 2021, 15 percent of Americans will have diabetes; one-third of our population will be pre-diabetic.”

The human and financial costs would be catastrophic—but can be avoided if a joint campaign to improve the health of workers succeeds. So in part, Total Health is a response to the high cost of health care.

“The employer told us the cost for health care for union members is too high,” says Walter Allen, the executive director of OPEIU Local 30 who is serving as interim director of the coalition. “The choices are A) shift more of the cost to workers or B) bring down the cost. We will take plan B. The main way to keep costs down is for people to be healthier and require less care. An incentive is a way to start people off—above and beyond the reward of being healthier.”

By lowering costs, the organization’s financial picture improves, which helps ensure KP’s success and longevity. Improving the health of our large employee population group also would demonstrate to other employers the value of this approach.

In exchange, KP “will leave cost sharing as it is,” says Allen, noting that at a time when many unions reluctantly were accepting concessions in their contracts, health insurance benefits for union coalition members remained unchanged in 2012 bargaining.

“We made a commitment, and now we have to come through,” Allen says.

Leading by example

But Total Health is more than the sum of economic interests. It’s about how KP and the coalition are leading the way to shift the culture of workplaces toward wellness. Frontline caregivers know they need only look in the mirror to see they suffer from many of the same ills as their patients. It’s time to lead by example.

“Healthy health care workers make for healthy communities,” says Stacey Anderson, an imaging assistant and UFCW labor partner at Sunnyside Medical Center in the Northwest. “I believe we can set the standard for others to follow.”

At KP, the growing emphasis on employee wellness is a natural complement to the preventive care model.

“We’ve got to create a culture where doing the right thing is the easier thing to do,” says Sylvia Swilley, MD, the physician Healthy Workforce champion at Downey Medical Center in Southern California, where Pop Chips (120 calories per bag) recently replaced Fritos (160 calories per bag) in the vending machines. “We can’t serve stuff in our cafeterias that we tell members in their health education class not to eat. We have to be the face of how to do it right.”

While many workforce wellness programs reward—and punish—individuals for their success or lack thereof, the KP plan will calculate results at the regional level.

“Some people will see it as unfair,” says Elba Araujo, a pharmacy assistant at Los Angeles Medical Center and UFCW Local 770 member. After all, the person who keeps smoking and gains weight might end up with the same bonus as the person who quits smoking and lowers her cholesterol. “But if people see results,” she says, “they will want to get involved.”

By offering programs such as KP Walk!, Mix It Up and the total health assessment, Kaiser Permanente is doing its part, says union leader Allen. In return, he says, the unions are saying, “We will do our part; we will educate our members.”

“We are in health care. We have to take care of ourselves,” says Judy Coffey, a senior vice president and area manager of the Marin-Sonoma Service Area in Northern California, who helped negotiate the plan. “Wouldn’t it be great to be able to say our employees have lowered their cholesterol, their blood pressure, their BMI?”

Around the Regions (Fall 2013)

Colorado

Employees in Colorado are well on their way to wellness. The region has had a wellness program since 2004, and for the last four years has had a cash incentive to encourage employees to participate in wellness activities. The results have been positive. From 2009 to 2012, employee obesity rates have dropped from 34 percent to 32 percent. In addition, the prevention index—a composite metric that reflects the percentage of employees who are tobacco free, up to date on preventive screenings for heart disease and cancer, and not obese—has risen, with women improving from a 46 percent rating to 52 percent, and men improving from 44 percent to 50 percent.

Georgia

The Georgia region used its social media channels, including Facebook, Twitter, Instagram and Pinterest, to showcase employees, physicians and executives who mobilized for the Atlanta 2-Day Walk for Breast Cancer in October. Photos of giant, costumed characters “Doc Broc” and “Nurse Blueberry” filled the region’s news feeds, along with pictures of KP’s walkers and supporters. By using hyperlinks and hashtags, KP’s teams could connect with others involved in the event to generate online buzz for the walk. “Doc Broc” also appears at the KP-sponsored farmers’ market at Piedmont Park and other events. When not tracking the cruciferous crusader, the social media pages keep a steady diet of healthy recipes, tips and links to blog posts by top executives to show KP and its partner unions’ joint commitment to total health.

Hawaii

Safety conversations are sweeping the islands, with every employee in the region striving for at least two conversations per month, thanks to an idea pioneered by the Ambulatory Surgery Recovery unit. Brightly colored “topic stimulator” cards encourage staff members to share tips in a safe, fun manner. “Sharp attack” cards keep safe needle-handling on point. “Whoa” cards steer employees toward safer patient transport and lifting. “I spy” cards safeguard confidentiality by prompting frank discussions about hallway conversations, snooping, unattended computers and the paper shredder. Christy Borton, RN, the regional workplace safety champion—and injury rates, which were already low, are staying that way “We never talked about safety. Now we do, all the time, in the most meaningful ways.”

Mid-Atlantic States

The region’s fourth annual Learning Conference will provide opportunities to enhance skills in education and learning. Two days of workshops will provide ways to help clinical health educators improve communication skills and leverage the latest patient education technology. Informed and educated patients can participate in treatment, improve outcomes, help identify errors before they occur and reduce length of stay. This free conference also is for anyone in the region who facilitates or supports learning, including those who will be involved in engaging staff in workforce wellness activities—technical and LMP trainers, consultants, managers and supervisors, and shop stewards. Sessions begin Friday, Nov. 1, in College Park, Md. To view the conference web page and register, go to learn.kp.org and search for KPMAS Annual Learning Conference.

Northern California

Marcus Barnes and Donna Norton have been named the region’s Total Health union champions. The Total Health positions help support implementation of the 2012 National Agreement. Barnes, an OPEIU Local 29 member, works in the regional Claims department. Norton, a member of SEIU UHW, is a licensed vocational nurse at the Vacaville Injection Clinic, serves as an executive board member of SEIU UHW for Vacaville and Fairfield, and is her facility’s union co-lead. The pair will work closely with local union leaders and managers to recruit and train local workforce wellness champions, help frontline employees understand the National Agreement’s Total Health Incentive Plan, and work to integrate workforce wellness and workplace safety at the front line.

Northwest

Staff in the Northwest are getting healthy and having fun at the same time. At the Beaverton Medical Office, staff members teamed up to lose weight and sweetened the deal with an informal competition. Those who met their personal goal then took part in a drawing for a prize. Overall, staff members at the medical office have lost 89 pounds. If you come by, don’t be surprised if you see staff doing Instant Recess®, push-ups in the back office or working in the community garden.

Southern California

Panorama City Medical Center has 52 busy “Thrive ambassadors,” who talk to their colleagues about Kaiser Permanente’s wellness programs. They also recently started one community walk per month, raising awareness and funds for Alzheimer’s disease, victims of violent crime and other causes. Holly Craft Moreno, who is quoted in the cover story of this issue of Hank, says the group is always recruiting new ambassadors—adding that it’s not necessary to be a “rock star who does a triathlon every day.” The willing are welcome, she says: “Some of us can’t walk as fast as others. There is always someone on our team who will slow down, too.”